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Nicolas Shared "GER 2" - 22 Picmonics

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GER 2

Hepatitis A (HAV) Assessment
Transmission
Fecal-Oral
Ingestion of Contaminated Food or Water
Incubation
4 Weeks
Assessment
Fever
General Malaise
Hepatomegaly
Considerations
Self-Limiting
Proper Hand Washing
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2 mins
Hepatitis B (HBV) Assessment
Transmission
Bodily Fluids
Blood Transmission
People Who Use IV Drugs
Incubation
Variable 1-6 Months
Assessment
Fever
Nausea and Vomiting
Hepatomegaly
Chronic Disease
Cirrhosis
Hepatocellular Carcinoma
Considerations
Vaccination
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2 mins
Hepatitis B Virus Disease
Can turn chronic
< 10% of adults become chronic carriers
90% of newborns become chronic carriers
Cirrhosis
Hepatocellular carcinoma
Membranous Glomerulonephritis
Polyarteritis nodosa
Serum sickness like syndrome
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2 mins
Hepatitis C (HCV) Assessment
Transmission
Blood Transmission
High Risk Sex (rare)
IV Drug Users
Incubation
7 Weeks
Chronic Disease
Cirrhosis
Considerations
Barrier Protection
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2 mins
Cirrhosis Assessment
Mechanism
Degeneration and Destruction of Liver Cells
Signs and Symptoms
Jaundice
Fatigue
Palmar Erythema
Spider Angiomas
Hepatosplenomegaly
Edema
Gynecomastia
Change in LOC
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2 mins
Cirrhosis Interventions
Interventions
Maintain Nutrition
Paracentesis
Esophageal and Gastric Varices
Drug Therapy
Endoscopic Band Ligation or Sclerotherapy
Balloon Tamponade
Transjugular Intrahepatic Portosystemic Shunt (TIPS)
Hepatic Encephalopathy
Lactulose
Antibiotics
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2 mins
Complications of Cirrhosis
Portal Hypertension
Ascites
Esophageal Varices
Coagulation Defects
Portal-Systemic Encephalopathy
Hepatorenal Syndrome
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1 min
Gilbert's Syndrome
Pathophysiology
Decreased UDP-Glucuronosyltransferase Activity
Decreased Bilirubin Conjugation
Signs and Symptoms
Often Asymptomatic
Jaundice (Mild)
Fasting
Stress
Alcohol Intake
Labs
Increased Unconjugated Bilirubin
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2 mins
Crigler-Najjar Syndrome Type 1
Pathophysiology
Autosomal Recessive
Absent UDP-glucuronosyltransferase
Symptoms
Neonatal Jaundice
Kernicterus
Diagnosis
Normal Liver Function Tests
Elevated Unconjugated Bilirubin
Treatment
Phototherapy
Plasmapheresis
Calcium Phosphate and Orlistat
Death often by Age 2
Considerations
No Response to Phenobarbital
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3 mins
Budd-Chiari Syndrome
Causes
Pregnancy and Postpartum
Hematologic Disorders
Tumors
Chronic Infections
Mechanism
Thrombosis of Major Hepatic Veins
Centrilobular Congestion and Necrosis
Symptoms
Abdominal Pain
Ascites
Hepatomegaly
Nutmeg Liver
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3 mins
Reye's Syndrome
Cause
Aspirin (Salicylates) to Treat Viral Illness (In Children)
Assessment
Cerebral Edema
Lethargy (Decreased LOC)
Vomiting
Liver Failure
Interventions
Monitor for Increased ICP
Mannitol (Osmitrol)
Considerations
No Aspirin for Children
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2 mins
Hemochromatosis Pathophysiology
Pathophysiology
Hemosiderin Deposition
Autosomal Recessive
HLA-A3
Secondary to Transfusion Therapy
Increase Iron
Increase Ferritin
Increased Transferrin Saturation
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2 mins
Hemochromatosis Signs and Symptoms
Signs and Symptoms
Micronodular Cirrhosis
Hepatocellular Carcinoma
Diabetes
Bronze Skin Coloring
CHF
Arthropathy
Testicular Atrophy
Impotence
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2 mins
Wilson's Disease Pathophysiology
Autosomal Recessive
Mutation in ATP7B gene
Chromosome 13
Decrease in Ceruloplasmin
Inadequate copper excretion
Liver
Brain
Kidney
Cornea
Joints
Treat with Penicillamine
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2 mins
Wilson's Disease Symptoms
Cirrhosis
Hepatocellular Carcinoma
Basal Ganglia Degeneration
Dementia
Dyskinesia
Asterixis
Kayser-Fleischer Rings
Slit Lamp Exam
Hemolytic Anemia
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2 mins
Primary Sclerosing Cholangitis Mechanisms
Mechanism
Unknown Mechanism
"Onion Skin" Fibrosis
"Beading" of Bile Ducts
Symptoms
Pruritus
Hepatosplenomegaly
Jaundice
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2 mins
Primary Sclerosing Cholangitis Labs and Treatment
Labs
Increased Conjugated Bilirubin
Increased ALK-P
Increased IgM
Associated Pathologies
Ulcerative Colitis
Cholangiocarcinoma
Secondary Biliary Cirrhosis
Treatment
Liver Transplant
Stent
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2 mins
Primary Biliary Cholangitis (Primary Biliary Cirrhosis)
Mechanism
Autoimmune Destruction of Bile Ducts
Intrahepatic bile ducts
Cholestasis
Occurs in Middle-Aged Females
Signs and Symptoms
Fatigue
Pruritus
Skin Hyperpigmentation
Hepatomegaly
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3 mins
Primary Biliary Cholangitis (Primary Biliary Cirrhosis) Diagnosis and Treatment
Diagnosis
Positive Antimitochondrial Antibodies
Increased Alkaline Phosphatase (ALK-P)
Increased Cholesterol
Treatment
Ursodiol
Liver Transplant
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2 mins
Cholecystitis Assessment
RUQ Pain
Referred Shoulder Pain
Clay Colored Stools
Jaundice
Nausea and Vomiting
Dyspepsia (Indigestion)
Fever
Considerations
Increased WBCs
Fatty or Spicy Foods
Ultrasound
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2 mins

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